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ACE, Achieving Clinical Excellence, Conference
May 2-4, 2018, Östersund, Sweden


This program might be subject to change (until the very last minute) due to circumstances outside our control.

PLEASE NOTE:  All conference presentations will be offered in English.

3rd May, Conference: Day One, 09.00-16.00

Morning Registration, Opening Ceremony, and Keynotes
<click here for details>

15.00-15.45 Workshop session 1.1

1. Implementation
Thomas Bjørn Hansen, Denmark
Management of fit in organizations:  To many people these days implementing fit seems to be the right answer to documenting and improving treatment outcome. 
 

It seems simple - just the use of two scales and we are on the way to improvement. And sure we should be able to have it fully implemented in six months..... all we need is the basic training - two days should probably do it. 
NOT TRUE! The fact is that implementation of fit is as complex and hard as it is rewarding and exiting.

This workshop focuses on management of fit implementation in organizations. The implementation process is conceptualized as three organizational feedback loops: f
eedback between client and therapist, feedback between case and therapist and finally feedback between organization and case.
 

With each feedback loop the complexity of the implementation increases and specific managerial tasks must be undertaken for the implementation to succeed. So if you are the manager of fit implementation and have found the implementation proces to be just a bit more complex than making staff use the scales this workshop could be of interest. And if you are a key staff member with the sisyfosian task to implement fit in your organization without strong commitment from management-make sure your manager attends.

Thomas Bjørn Hansen is manager of Poppelgården Familiecenter in Hvidovre Denmark where fit has been implemented over the last five years. He also works as fit trainer and superviser helping other agencies implement fit.

2. Supervision
Laura Tang Jensby, Rasmus Møller, & Susanne Bargmann, Denmark 

FIT-Supervision in an agency setting. In this workshop we will describe a FIT Supervision Model that can be used to structure clinical conversations about outcome and alliance data. The model is a simple 3-step model, allowing clinicians to focus very specifically on the client’s feedback in the supervision process.


Laura Tang Jensby and Rasmus J. Møller have worked with the FIT Supervision Model in their own agency for the past seven years, and will present their experiences in working with the FIT Supervision model with their colleagues. They will describe how they have structured, adjusted and carried out the supervision with their peers and how this has effected the center´s professional development and clinical outcomes the past seven years. 

Laura Tang Jensby is an ICCE Certified Trainer working in a family center in Gladsaxe Municipality, Denmark. Laura is an experienced FIT practitioner, trainer and consultant and has written several articles about working with FIT in family settings.

Rasmus J. Møller is an experienced FIT practitioner working in a family center in Gladsaxe Municipality, Denmark. Rasmus is leading a project in the organisation, where the aim is to implement FIT with the intake workers / the social workers in the organisation.


Susanne Bargmann has over 8 years of experience working with CDOI / FIT with various populations. She has specialized in treating eating disorder problems, and is part of organizing and teaching a national education for professionals in Denmark working with eating disorder problems. See more under Keynotes.

Bram Bovendeerd Bram Bovendeerd

 3. When does PCOMS work? Preliminary results of a PCOMS study in basic mental health care; effect-size, therapist-characteristics  & patient-perspectives 

Bram Bovendeerd, Nederland
Background: The Partners of Change Outcome Management System (PCOMS) is a client feedback-system, developed in the USA and widely applied in mental health care around the world. Prior studies of PCOMS vary considerably in scientific rigor. Studies with an independent outcome measure have found effects varying from significant to even a negative effect so far. The aims of the present study are (1) to test the predicted beneficial impact of PCOMS while accounting for some methodological flaws in prior studies and (2) to clarify under which circumstances the addition of PCOMS to treatment has a beneficial effect on treatment outcome.

Methods: The multicenter study focuses on clients applying for brief, time-limited treatments. The study will be conducted as a cluster randomized controlled trial. Four centers will participate: two in the experimental and two in the control condition. All therapists in this condition will fill in a questionnaire concerning the influence of regulatory focus, self-efficacy, external or internal feedback orientation and perceived feedback validity on the effect of PCOMS. During the study, patients selected in the feedback condition will be asked if they would be willing to give feedback through a structured interview about their experience of using PCOMS.

Presentation: In this presentation the background of this study, the preliminary results on treatment outcome (in terms of patient satisfaction, drop-out, effectiveness of treatment and cost-effectiveness), therapist-characteristics  & patient-perspectives will be presented.

Bram Bovendeerd, clinical psychologist and psychotherapist, works at the Specialist Centre for Developmental Disorders (SCOS) of Dimence in The Netherlands, is a lecturer and PhD candidate at the University of Groningen and member of the editorial board of the ‘Tijdschrift voor Psychotherapie’, the Dutch Journal of Psychotherapy.

4. FIT in long-term social psychiatric setting
Finn Blickfeldt Juliussen, Socialstyrelsen, Denmark
Using FIT in the prevention of threats, violence and use of force in social-psychiatric residential care facilities.  The National Board of Social Services, Denmark

Introduction: The project was initiated in 2013 in the light of the fact that research shows that 46 percent of all specialized social-workers in Denmark have excperienced threats within the last twelve months, and 38 percent have been subjected to violence.

Aims: A reduction of the extent of threats, violence and use of force.
Methods The project initiatives encourage the use of FIT and Low Arousal which 1) partly lead to solution-focused communication skills for both staff and citizen, and 2) partly train preventive practices.

Results: The project was finished in 2017, and the following results were found a significant reduction of violence and use of force, and staff experiences the methods FIT and Low Arousal to be useful. The job satisfaction of the staff-members and the well-being of the citizens were found to be increased. The methods support recovery, empowerment and enhanced coping-skills. From being part of a project, the methods are undergoing permanent implementation and are set in operation in major Danish municipalities, including Copenhagen.

Conclusions: FIT and Low Arousal facilitate a culture change characterized by increased dialogue orientation. This leads to  supporting/enhances the support needed in order to favour the citizen’s goals (and wishes)  in relation to well-being and living the good life (personal recovery).             
                                            

We now know that this will lead to a reduction of the extent of threats, violence and use of force in psychiatric residential facilities.


Finn Blickfeldt Juliussen is a special consultant, project-manager,The National Board of Social Services, Denmark

 

Marlene Stockholm Marlene Stockholm

5. Children, Collateral Ratings 
Marlene Stockholm, Denmark
Going beyond therapy: Using FIT as a compass to stay on course in complex work with children and their families and network


Working with children and their families and professional network (eg. social worker, teachers, P.E., mentor etc.) calls for collaboration and coordination – something that is easily said, but can be very challenging to do. Parents and professionals are eager to help but will often have different problem definitions and therefore different ideas of interventions and goals. Potentially this can cause power struggles of whose methods are most effective, and a general lack of coordination between professionals, and professionals and the family – none of which will support the child.

Even though FIT was developed as a therapeutic tool, the scales have proven to have value in supporting complex work of collaboration and coordination with social workers and other professionals. Using FIT does not solve the inherent problem of potential system disintegration but it disciplines our focus on the goal: improvement of the child’s well-being. The FIT graphs also offer help in managing and keeping an overview of the case and discovering risks of disintegration.

Catja Mosgaard       and          Henrik H.Hansen Catja Mosgaard and Henrik H.Hansen

6. FIT in short-term therapeutic setting
Henrik H.Hansen & Catja Mosgaard, Denmark
What would you do if you had only 5 sessions available?  Would you still use FIT?  Would you use it differently? Why?
 We will show how the usage of FIT has benefitted our clients in the framework of short-term treatment, e.g. by zooming in on the therapeutic task and keeping our clients engaged in an early stage of the treatment. We will then engage you (via an exercise) in the discussion of the dilemmas in a short- term setting: how does FIT apt into an organizational setting with a time-limited offer (max 5, 10, 15 sessions)? Is the usage of FIT meaningful in very short treatments (1-3 sessions)?
 

7. How does the consumer/client experience working with FIT, Video on User experience of FIT
Else Brunvand , Gritt Bonde & Jonas Friedrichsen, Denmark
Our presentation will focus on how the client experience working with FIT and how this contribute to the treatment itself. In the presentation we will focus mainly on two aspects of this. The first aspect is on how the client make sense of FIT and how this contribute to the treatment itself. The other aspect is how we as therapist can facilitate this meaning for the client and help integrate it in treatment.Our presentation will be built on different case examples and create the opportunity for dialog with the audience about the topic.

 

8.  When FIT does not improve outcome: Barriers to the effect of FIT in group psychotherapy for patients with eating disorders.
Annika Helgadóttir Davidsen, Faroe Islands 
This workshop is based on the results from the F-EAT research project in which we aimed to investigate the effect of FIT in group psychotherapy on attendance and treatment outcome for patients with eating disorders.

We conducted a randomized clinical trial, and included 159 adult participants diagnosed with bulimia nervosa, binge eating disorder, or eating disorder not otherwise specified according to DSM–IV. Both groups received 20-25 sessions of systemic and narrative group therapy. In the experimental group, participants gave and received feedback (ORS and GSRS) about therapy progress and alliance.
 

The results showed that FIT neither increased attendance nor improved outcomes for patients in group psychotherapy for eating disorders. In the workshop, I will discuss the results and possible barriers for positive effects of FIT.

Kim de Jong Kim de Jong

9. Differential Impact of feedback on practitioners
Kim de Jong, Nederland
This workshop will present the results of several studies in which therapist characteristics moderate feedback effects, as well as attitude towards using feedback systems. The latest study shows that feedback advises the therapist's expectations of outcome (towards more realistic outcomes). This is especially true for feedback that also measures the therapy process (in this case through the clinical support tools). With this, we have uncovered a potential mechanism of action in feedback.

This presentation will offer the results of several studies in which therapist characteristics moderate feedback effects, as well as attitude towards using feedback systems. The latest study under discussion shows that feedback adapts the therapists expectations of outcome (towards more realistic outcomes). This is especially true for feedback that also measures the therapy process (in this case through the clinical support tools). This demonstrates a potential mechanism of action in feedback.

 

​​​​10. System-wide implementation in Swedish social authorities, Halmstad socialförvaltning
Erica Manderhjem, Sweden
This  presentation will examine the process of implementation in Halmstads kommun social services.

Many aspects of the program in Halmstad have been well planned, well supported and financed – and still the outcome is on a range from pilots not even trying – to close to full implementation in some cases.In short, my attempt is to describe progress and difficulties and also to discuss possible explanations. I will try to analyse my findings from a cultural context .


The workshop will also consider:​​​​​
  • The importance of giving support to the pilot groups so that they actually make use of the feedback they receive – to avoid measuring becoming an administrative task.
  • The importance for management to measure quality by input, output AND outcome ( how much resources did we spend, how many services did we provide AND how much use was it in the eyes of the consumers)
  • The importance of having a culture of feedback throughout the organization, for feedback in clinical work to grow
  • The importance of engaged leadership within the pilot unit as well as from the top down.

<back to workshop schedule>
 

This program might be subject to change (until the very last minute) due to circumstances outside our control.